scholarly journals Probable Hydrochlorothiazide-Induced Myopericarditis: First Case Reported

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Toufik Mahfood Haddad ◽  
Muhammad Sarfraz Nawaz ◽  
Ahmed S. Abuzaid ◽  
Smrithy Upadhyay ◽  
Pallavi Bellamkonda ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Past History ◽  
Uncontrolled Hypertension ◽  
African American Female ◽  
Pericardial Disease ◽  
First Case ◽  
Segmental Wall Motion ◽  
Segmental Wall ◽  
History Of ◽  
Artery Disease

Hydrochlorothiazide has never been reported as a reason for myopericarditis. An African American female, with past history of hypertension, coronary artery disease, and sulfa allergy, presented with indolent onset and retrosternal chest pain which was positional, pleuritic, and unresponsive to sublingual nitroglycerin. Her medications included hydrochlorothiazide (HCTZ) which was started three months ago for uncontrolled hypertension. Significant laboratory parameters included erythrocyte sedimentation rate (ESR) of 47 mm/hr and peak troponin of 0.26 ng/mL. Transthoracic echocardiogram (TTE) revealed preserved ejection fraction with no segmental wall motion abnormalities; however, it showed moderate pericardial effusion without tamponade physiology. We hypothesize that this myopericarditis could be due to HCTZ allergic reaction after all other common etiologies have been ruled out. There is a scarcity of the literature regarding HCTZ as an etiology for pericardial disease, with only one case reported as presumed hydrochlorothiazide-induced pericardial effusion. Management involves discontinuation of HCTZ and starting anti-inflammatory therapy.

scholarly journals Mesothelioma in two sheep with pericardial effusion and ascites

2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Domestic Animals ◽  
Diagnostic Pathology ◽  
First Case ◽  
Clinical Presentations ◽  
Rare Tumours ◽  
Microscopic Features ◽  
History Of ◽  
The Right

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.

scholarly journals Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
S. Guerriero ◽  
G. Infante ◽  
E. Giancipoli ◽  
S. Cocchi ◽  
M. G. Fiore ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Past History ◽  
Bone Biopsy ◽  
Biopsy Specimens ◽  
First Case ◽  
History Of ◽  
Previously Treated ◽  
Carcinoma Metastasis ◽  
End Stage ◽  
Irregular Mass

Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease) with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient.

scholarly journals ACUTE HEART FAILURE

2018 ◽  
Vol 25 (09) ◽  
pp. 1392-1396
Author(s):  
Jasia Reham Din ◽  
Shahid Maqbool ◽  
Shakeel ur Rehman ◽  
Naeem Hameed
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
De Novo ◽  
Past History ◽  
Previous History ◽  
Young Male ◽  
Uncontrolled Hypertension ◽  
Cross Sectional ◽  
History Of ◽  
Emergency Department Patients

Objectives: To determine the frequency of the major precipitating factorsamong the patients presenting with acute heart failure. Study Design: Cross sectional study.Setting: Faisalabad Institute of Cardiology, Faisalabad. Period: July 2014 to January 2015.Materials and Methods: 190 patients of acute heart failure were included after obtaininginformed consent from emergency department. Patients from age of 25 years to 80 years andof either sex either diabetic or non-diabetic were enrolled in study. ECG and CXR were takenin emergency with baseline investigations. Precipitating cause was identified from collectedhistory, clinical examination and ECG, CXR and lab results. Results: Mean age of these patientswere 54.4 + 8.92, 100 (52.6%) were male, 90 (47.4%) were females, 88 patients (46.3%) werediabetic, 102 patients (53.68%) were non-diabetic and 124 (65.3%) had previous history of heartfailure and 66 (34.7%) had no past history of heart failure. ACS was the common precipitatingfactor of Acute Heart Failure ( 31.57% ) among all the patients of the study with non-complianceof drugs 27.9% , arrhythmias 17.9% uncontrolled hypertension 17.36% and infections 5.3%.Conclusion: Young, male, diabetics and patients with history of chronic HF suffered more fromAHF. ACS was the most common precipitating factor while in patients with de novo Acute HeartFailure; it was ACS and non-compliance with drugs.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

Levels of Activated FXII in Survivors of Myocardial Infarction – Association with Circulating Risk Factors and Extent of Coronary Artery Disease

1998 ◽  
Vol 79 (01) ◽  
pp. 14-18 ◽  
Author(s):  
Hans Kohler ◽  
Angela Carter ◽  
Max Stickland ◽  
Peter Grant
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Past History ◽  
Factor Xii ◽  
Factor Xiia ◽  
History Of ◽  
Artery Disease ◽  
Coronary Atheroma ◽  
Pai 1

SummaryLittle data is available regarding the activated form of factor XIIa (FXIIa) in survivors of myocardial infarction. 292 Caucasian patients characterised for extent of coronary atheroma by angiography and for a past history of myocardial infarction and 77 healthy controls were included in the study. To investigate the relationship between coronary artery disease, activated factor XII and other circulating factors, we studied levels of FXIIa, cholesterol, triglycerides, fasting insulin, fibrinogen, FVII:C, t-PA antigen and PAI-1 antigen. Factor XIIa levels were higher in all patients [2.5 (2.3-2.6) ng/ml] and in patients with a history of MI [2.6 (2.4-2.9) ng/ml] than in controls [1.9 (1.7-2.1) ng/ml], p <0.0001. In patients, FXIIa levels positively correlated with FVII:C, BMI, cholesterol, insulin, PAI-1 antigen, t-PA antigen and triglycerides. In controls FXIIa levels only correlated with PAI-1 antigen and triglycerides. FXIIa levels were strongly associated with extent of coronary stenosis: 2.8 (2.6-3.1) ng/ml and 2.6 (2.3-2.9 ng/ml) in those with 2 and 3 vessels stenosed compared to 2.1 (1.9-2.3) ng/ml in those with 0 vessel stenosed (p = 0.0004). Activated FXII relates to both extent of coronary atheroma and to a past history of myocardial infarction and clusters with features of insulin resistance.

Cardiac Tamponade - A Hypothyroidism Associated Emergency: A Report of 2 Cases

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Tripathi S ◽  
◽  
Sharma JB ◽  
Vijayvergia P ◽  
Khichar S ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Young Female ◽  
Medical Emergency ◽  
Myxedema Coma ◽  
First Case ◽  
History Of ◽  
Medical Emergencies ◽  
Recurrent Pericardial Effusion

Pericardial effusion in commonly seen in-patient with hypothyroidism but effusion large enough to cause cardiac tamponade is not a common presenting feature whereas myxedema coma is a commonly defined medical emergency in-patient with hypothyroidism. We report 2 cases of hypothyroid associated medical emergencies. First case is a young female with history of recurrent pericardial effusion presenting to the emergency department with cardiac tamponade and later on diagnosed as having hypothyroidism. The second patient is a known case of hypothyroidism non-compliant to thyroid supplement and presented with lethargy, fatigue, decreased talking and breathlessness who was later diagnosed as having myxedema coma and impending cardiac tamponade. Both the patient required percutaneous pericardiocentesis and improved with medical management.

The “Natural History” of Segmental Wall Motion Abnormalities in Patients Undergoing Noncardiac Surgery

1990 ◽  
Vol 73 (4) ◽  
pp. 644-655 ◽  
Author(s):  
Martin J. London ◽  
Julio F. Tubau ◽  
Martin G. Wong ◽  
Elizabeth Layug ◽  
Milton Hollenberg ◽  
...  
Keyword(s):  
Natural History ◽  
Wall Motion ◽  
Noncardiac Surgery ◽  
Segmental Wall Motion ◽  
Segmental Wall ◽  
History Of ◽  
Wall Motion Abnormalities
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